Tag Archives: cuniff

Naloxone: A Powerful Tool to Fight Opioid Overdose

By: ANDREA C. CUNIFF, M.D.

The opioid crisis continues in Maryland and has gotten worse as the powerful drug fentanyl is increasingly mixed into illegal drugs. From 2022 to 2023, the state saw 2,583 fatal overdoses, and fentanyl was involved in about 81% of those deaths.

In response, there has been a growing use of naloxone (commonly known by the brand name NARCAN®), a medication approved by the Food and Drug Administration that rapidly reverses opioid overdose. It has been used to save lives in Maryland. Healthcare officials encourage its distribution and use by the public.

What is naloxone?

Naloxone is an opioid antagonist: it attaches to opioid receptors in the body, reversing and blocking the effects of opioids, including heroin, morphine and oxycodone. Naloxone can quickly restore normal breathing to a person whose breathing has slowed or stopped because of an opioid overdose. However, it only reverses opioids and will not work on other drugs like cocaine or methamphetamine.

How naloxone is given

Naloxone should be given to any person who shows signs of an opioid overdose. It can be administered as a nasal spray or an injection. Learn how to respond to an overdose with guidelines from the Maryland Department of Health.

Signs of opioid overdose

  • The person’s face is extremely pale and/or feels clammy to the touch
  • Their body goes limp
  • Their fingernails or lips have a purple or blue color
  • They start vomiting or making gurgling noises
  • They cannot be awakened or are unable to speak
  • Their breathing or heartbeat slows or stops

Source: Substance Abuse and Mental Health Administration

Who can give naloxone?

Naloxone is widely used by police officers, emergency medical technicians (EMTs) and non-emergency first responders. In Maryland, anyone can administer naloxone and training is not required, but your healthcare provider or pharmacist can advise you how to use it.

You can buy naloxone at a pharmacy without a prescription. Free naloxone may also be available from Overdose Re​sponse Programs located throughout the state.

What to keep in mind

Naloxone works for about 30 to 90 minutes, but many opioids remain in the body longer than that, so a person can still experience the effects of an overdose after naloxone wears off. If you administer naloxone to an overdose victim, you should still call 911 as soon as possible for immediate medical attention.

Side effects from naloxone are rare, but some people might have allergic reactions to it. Overall, naloxone is a safe medicine and has the potential to save many lives.

In the state of Maryland you are protected under the Good Samaritan Law. This means you will not be arrested or prosecuted if you administer naloxone while you are under the influence of alcohol or illicit drugs, or are in possession of illicit drugs at the time of administration.

More about naloxone

 

Dr. Cuniff treats patients in the Annapolis office. She is certified by the American Board of Family Medicine and earned her medical degree from the University of Maryland School of Medicine.

Will My Child Be Safe at School?

BY: ANDREA C. CUNIFF, M.D.

Maryland children are finally returning to the classroom. This is welcome news for most families, but some parents wonder whether their kids will be safe from COVID-19 at school.

Maryland schools are taking precautions to protect children and staff members, including social distancing, mask wearing, limited class size and stepped-up cleaning. So as reported in Maryland School Reopening Guidance from the Maryland Department of Education, schools are pretty safe when it comes to the coronavirus. Here are some highlights from the report:

    • Many fewer children have been infected with COVID-19 than adults.
    • Children are less likely to become infected than adults.
    • Children under 10 appear to not spread the virus as much as adults.
    • Children generally have milder cases of the disease and lower rates of hospitalization.
    • Spread of the virus in schools is uncommon when prevention strategies are used effectively.
    • When Covid-19 does spread in schools, it is much more likely to be between staff members than between staff and children.
    • From Aug. 10, 2020 to Jan. 10, 2021, only 4.3% of persons 19 years or younger who got COVID-19 said they had attended or visited in a pre-K-12 school. That means most were not infected at school.
    • Maryland has prioritized vaccination of educators and staff in all K-12 schools. This is underway now.

See public and non-public K-12 schools that have reported Covid-19 cases

While schools are taking precautions, you should remind your children to protect themselves with these safe practices:

  • Stay separated (at least three feet, according to the latest CDC guidance): This includes not bunching up while standing in line, leaving space between seats at lunch, and not getting too close to others at recess.
  • Wear face masks: This should be a priority, especially when it’s hard to maintain social distance, such as on the bus or entering the school building. Wear cloth masks or the disposable medical face masks that are now widely available at grocery and drug stores.
    • Give your child a clean mask and back-up mask each day and a clean, resealable bag for them to store the mask when they can’t wear it, such as at lunch.
  • Keep hands clean: Practice hand-washing at home with your child: soap and water for at least 20 seconds. Encourage them to wash before and after eating or after coughing/sneezing. If hand washing isn’t available, use hand sanitizer.
  • Stay home if sick: Children should stay home if they have tested positive or are showing any COVID-19 symptoms:
    • Fever or chills
    • Cough
    • Shortness of breath or difficulty breathing
    • Fatigue
    • Muscle or body aches
    • Headache
    • Loss of taste or smell
    • Sore throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea

Dr. Andrea C. Cuniff earned her medical degree at the University of Maryland School of Medicine and is certified by the American Board of Family Medicine. She sees patients in the Annapolis office.

Got Friends? You’ll Live Longer

People with strong social networks tend to be healthier, live longer and are happier.

By: Andrea C. Cuniff, M.D.

You’re probably familiar with the social benefits of friendship. Our friends:

  • Increase our sense of belonging and purpose
  • Boost our happiness and reduce our stress
  • Improve our confidence and self-esteem
  • Help us cope with trouble, such as serious illness, job loss or the death of a loved one

Now, there’s a growing body of research showing that strong friendships can also improve your health. Adults with good social support have a reduced risk of many significant health problems, including depression, high blood pressure and obesity. Women have better odds of surviving ovarian and breast cancers, and both sexes live longer after surviving a heart attack.

In fact, a recent study of older adults found that those with large circles of friends lived 20% longer than others with fewer friendships.

Despite the proven benefits of friendship, many of us find it difficult to maintain existing relationships or make new ones.  In our busy lives, time with friends takes a backseat to jobs, children and other responsibilities. Or maybe you moved to a new community and haven’t met many people yet.

It’s also important to remember that when it comes to friendship, quality counts more than quantity. It’s good to have a big circle of friends, but you also want to cultivate a few truly close ones who will always be there for you.

Nurturing friendships

Maintaining friendships takes time and effort.  Try these tips to keep your existing relationships healthy:

  • Practice kindness. Think of friendship as an emotional bank account. Each kind deed and word is a deposit into this account, while criticism and negativity reduce the balance.
  • Listen closely: Ask what’s going on in your friends’ lives and pay close attention to their responses. When they share details of hard times, be sympathetic but don’t give advice unless they ask for it.
  • Open up about yourself. Being willing to disclose personal experiences and concerns shows that your friend holds a special place in your life, and it deepens your connection.
  • Show that you can be trusted. Follow through on commitments you’ve made. When your friends share confidential information, keep it private.
  • Make yourself available. Building a close friendship takes time. Make an effort to see new friends regularly, and to check in with them in between.

Making new friends

It’s just as important to expand your circle of friends. Look at your existing social network for possible new connections. Think about people who:

  • You’ve worked or taken classes with
  • You’ve been friends with in the past but have lost touch
  • You’ve enjoyed chatting with at social gatherings
  • You share family ties with

If anyone stands out, reach out. Extend an invitation to coffee or lunch, or ask a mutual friend to introduce you. You will need to be persistent, and you may need to meet a few times before you can tell if this new relationship will work out.

Other good ways to make friends include:

  • Attend community events: Look for groups or clubs that gather around an interest or hobby you share.
  • Volunteer: You can form strong connections when you work with people who have mutual interests.
  • Join a faith community:  Attend special activities and events for new members.

Starting and keeping friendships takes time and commitment. But it’s an investment that can pay off in better health and a happier life for you and your friends.

Dr. Andrea Cuniff received her medical degree from the University of Maryland School of Medicine and completed her residency program in Family Medicine at Franklin Square Hospital Center. She is certified by the American Board of Family Medicine and sees patients at MPCP’s Annapolis office.

Tired & Weak? You May Have an Iron Deficiency

by Andrea Cuniff, MD

Do you feel weak and tire easily? Are you short of breath? Look pale?

When I see patients with these symptoms, I suspect they may be suffering from anemia caused by an iron deficiency. Iron deficiency is due to too little iron in your body. It is the most common nutritional deficiency and the leading cause of anemia in the United States, especially among women.

Iron is important because your blood needs it to carry oxygen through your body. If you do not have enough iron, your body makes fewer and smaller red blood cells, and you cannot get enough oxygen.

In my practice, I’ve seen people develop iron deficiency for different reasons:

  • Adolescent girls and women of childbearing age due to menstruation
  • Young children and pregnant women because of rapid growth and higher iron needs
  • People with internal bleeding due to ulcers, hemorrhoids or cancer
  • Those with medical conditions that prevent absorption of iron, such as celiac disease or having part of their stomach or small intestine removed
  • People whose diets do not provide enough iron sources

You may not notice the symptoms of anemia at first because it develops slowly. But as anemia gets worse, you may:

  • Feel weak and tire out more easily
  • Feel short of breath
  • Feel dizzy
  • Have headaches
  • Look very pale
  • Have trouble concentrating
  • Have an inflamed tongue (glossitis)

Also, babies and small children with anemia may:

  • Have a short attention span
  • Grow more slowly than normal
  • Develop skills such as walking and talking later than normal

Left untreated, anemia may cause fatigue so severe that you can’t even complete everyday tasks. It may also lead to a rapid or irregular heart beat (arrhythmia) and even congestive heart failure.

If you suspect you or someone in your family has anemia, see your MPCP doctor. We will do a physical exam and ask you questions about your medical history and your symptoms. We will also run some blood tests. These tests may include a complete blood count to look at your red blood cells and an iron test that shows how much iron is in your blood.

Treatment for iron-deficiency anemia will depend on its cause and severity. Treatments may include dietary changes and supplements, medicines or surgery.

I also recommend that people help prevent nutrition-based iron deficiency with a diet that includes good sources of iron. For a list of dietary sources of iron, see this article by the National Institutes of Health, Office of Dietary Supplements.

Dr. Andrea Cuniff sees patients in MPCP’s Annapolis office. She is certified by the American Board of Family Medicine.